Pain Packs: Reducing Risk of Opioid Addiction for New Mothers

Physicians with TriHealth Women’s Services are meeting the national opioid epidemic head-on through the use of a pain pack program designed to lessen the dependency on opioid painkillers in the management of postpartum pain for both vaginal and cesarean deliveries. The program has been piloted by physicians with TriHealth Associates in Ob-Gyn and has recently been implemented in the other TriHealth practices. The program has already significantly reduced the number of patients leaving TriHealth hospitals needing a prescription for opioid painkillers to treat postpartum pain.

According to the National Institute on Drug Abuse (NIDA), more than 115 people die in the United States every day from overdose of opioids, including prescription pain relievers, heroin and synthetic fentanyl. Over prescription of opioid pain relievers is gaining more focus as a cause of high addiction rates. NIDA studies support this claim citing the following statistics:

An estimated 4 to 6 percent who misuse prescription opioids transition to heroin.

About 80 percent of people who use heroin first misused prescription opioids.

Recently giving birth, new mothers are at increased risk of prolonged usage of opioids, often leading to long-term abuse and addiction and sometimes overdoses in the period following delivery.

“This is a big-time problem,” says Michael Marcotte, MD, Directory of Quality and Safety for TriHealth’s Women’s Services and a Maternal and Fetal Specialist with TriHealth’s Tri-State Maternal Fetal Medicine Associates. “It happens more often with patients who have delivered through cesarean section, where one in three hundred patients prescribed opioid painkillers are still using them after a year. In most cases, that pain should be manageable without medication within a week.”

Dr. Marcotte says while there is risk of addiction or overdose for many patients after surgery, there are specific circumstances adding to that risk for new mothers.

“New mothers are often sleep deprived,” he says. “With so much time and energy focused on taking care of a baby, it’s easy for a sleep-deprived mother to become confused and lose track of when they took their medication and how much.”

The fact that many new mothers have not taken opioid pain medication before and are unaware of the effects or risks associated with opioid painkillers can also contribute to issues, according to Dr. Marcotte. He also points out that just like any patient dealing with psychological conditions, women dealing with post-partum depression are at a higher risk to develop an addiction.

According to Dr. Marcotte, TriHealth’s postpartum pain pack program follows guidelines established by the American College of Obstetrics and Gynecologists. TriHealth nurses work with patients while they are in the hospital to fully understand their level of discomfort and establish a round-the-clock schedule of ibuprofen and acetaminophen to help patients stay ahead of the pain.

“Decreasing the risks of opioids is only one of the benefits of this program,” Dr. Marcotte says. “Mothers are also more alert and better able to tend to their newborns. Plus, in many cases, the combination of medications not only works as well as opioids, it often provides more consistent and reliable pain relief.”

One such patient is Jamie Ryan, who gave birth in September, 2108 via cesarean section at Good Samaritan Hospital, six years after her first delivery via the same procedure. She was treated according to the pain pack program after having a negative experience with opioid painkillers the first time around.

“We tried a couple different options last time, but I didn’t do well with either of them,” she says. “I felt sick and I was out of it the whole time. It was like I couldn’t get my head off the pillow.”

Jamie claims the pain relief using the pain pack was about the same as when using the opiate painkillers, but without the side effects of drowsiness and vomiting.

“This experience was so much better,” she says. “I knew what was going on through everything, I wasn’t as tired and most importantly, I was able to take care of my baby.”